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An interesting and important contribution to gait retraining after stroke

Alberto Esquenazi
(2012-02-13 15:13) MossRehab

The study is retrospective and has some methodological weakness but even with this
the authors bring forward a proposal for an innovative therapeutic approach namely
"Body Weight Supported Robotic Gait Training" that is of value particularly in the
early phase of rehabilitation when patients are limited by their capacity to participate
in high intensity, high repetition walking as a therapeutic intervention.

The authors did not mention that there may be different mechanisms involved in the
intervention they generically termed as "Body Weight Supported Robotic Gait Training".
Several of this devices are now available and two primary approaches to this technology
exist.
1. End Effector devices as the one used in this study which do not constrained hip
and knee joint motion allowing some variability in the kinematic pattern during walking
and
2. Robotic guided movement which consists of an exoskeleton that independently controls
in an active manner each hip and knee position during walking and provides passive
control at the ankles.
The approaches for each one of these two methods of intervention are not the same
and not clearly understood or differentiated in the literature.

Their work is an encouragement for others to further evaluate these new technologies
and to look in a more scientific manner how to select the appropriate patient population
as well as the timing, dosing and intensity of the intervention that will best serve
the patients we care for.